Regional anesthesia and pain medicine
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Reg Anesth Pain Med · Jan 2016
Randomized Controlled Trial Multicenter StudyEfficacy and Safety of Methylnaltrexone for Opioid-Induced Constipation in Patients With Chronic Noncancer Pain: A Placebo Crossover Analysis.
In patients with chronic noncancer pain, subcutaneous methylnaltrexone for opioid-induced constipation (OIC) was examined in a randomized controlled trial (RCT) followed by an open-label extension (OLE). This study examined the reproducibility of RCT findings by analyzing data from placebo-treated patients who crossed over to methylnaltrexone. ⋯ Findings during placebo treatment further establish the profile of OIC and support that little or no gastrointestinal tolerance develops across time. Findings under open-label conditions established the reproducibility and durability of methylnaltrexone for OIC.
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Reg Anesth Pain Med · Jul 2015
Randomized Controlled Trial Multicenter Study Comparative StudyA Randomized Comparison Between Single- and Triple-Injection Subparaneural Popliteal Sciatic Nerve Block.
This prospective randomized trial compared ultrasound-guided single-injection (SI) and triple-injection (TI) subparaneural popliteal sciatic nerve block. We hypothesized that multiple injections are not required when local anesthetic (LA) is deposited under the paraneurium because the latter entraps LA molecules, ensuring circumferential spread around the nerve. Therefore, in addition to comparable success rates, we also expected similar total anesthesia-related times (sum of performance and onset times) and designed this study as an equivalency trial. ⋯ Ultrasound-guided SI and TI subparaneural popliteal sciatic nerve blocks result in comparable success rates and total anesthesia-related times. Expectedly, the SI technique requires fewer needle passes.
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Reg Anesth Pain Med · Jul 2015
Multicenter Study Comparative StudyMedial Branch Blocks or Intra-Articular Injections as a Prognostic Tool Before Lumbar Facet Radiofrequency Denervation: A Multicenter, Case-Control Study.
Medial branch blocks (MBBs) and intra-articular (IA) facet joint injections are both used to diagnose facet joint pain and are presumed to be equivalent. No study has sought to determine which has a better prognostic value before radiofrequency (RF) denervation. ⋯ When used as a prognostic tool before lumbar facet radiofrequency, MBB may be associated with a higher success rate than IA injections. Our results should be confirmed by large, prospective, randomized studies.
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Reg Anesth Pain Med · Jul 2015
Multicenter StudyDevelopment and Validation of an Assessment of Regional Anesthesia Ultrasound Interpretation Skills.
Interpretation of ultrasound images and knowledge of anatomy are essential skills for ultrasound-guided peripheral nerve blocks. Competency-based educational models promoted by the Accreditation Council for Graduate Medical Education require the development of assessment tools for the achievement of different competency milestones to demonstrate the longitudinal development of skills that occur during training. ⋯ This study provides evidence for the reliability, content validity, and construct validity of a 47-item multiple choice-style online test of ultrasound interpretation skills for regional anesthesia, which can be used as an assessment of competency milestone achievement in anesthesiology training.
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Reg Anesth Pain Med · Jan 2015
Randomized Controlled Trial Multicenter StudySufentanil Sublingual Tablet System for the Management of Postoperative Pain Following Open Abdominal Surgery: A Randomized, Placebo-Controlled Study.
This study evaluates the efficacy and safety of a sufentanil sublingual tablet system (SSTS) for the management of postoperative pain following open abdominal surgery. ⋯ These results suggest that SSTS is effective and safe for the management of postoperative pain in patients following open abdominal surgery.